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Otto Warmbier bows during a news conference in Pyongyang, North Korea (Image: Reuters)

Trial of Otto Frederick Warmbier (Image: AFP)

A North Korean propaganda poster (Image: REUTERS/KCNA via Reuters TV)

Mr Warmbier, who travelled to North Korea with China-based Young Pioneer Tours, was arrested in the capital Pyongyang in January last year for allegedly stealing a propaganda poster at a hotel.

In March last year, he confessed and apologised as he delivered a televised statement praising the country's legal system and "humanitarian treatment" of criminals.

Past detainees have recanted their confessions once released and told how they were forced to admit to a crime.

The coroner's report, obtained by the Cincinnati Enquirer found that Mr Warmbier's body was "well-developed" and "well-nourished" when he returned to the state of Ohio.

Otto Warmbier confessed to "severe crimes" against the state (Image: Reuters)

Kim Jong-Un (Image: KCNA)

It listed at least 10 small scars, at least half of which were pale, suggesting they were older.

Newer scars with bruising, including one on the right side of his neck, could have been from medical treatment such as an intravenous line, while another at the top of his sternum was consistent with the insertion of a breathing tube.

The post mortem examination by a Hamilton County coroner listed his cause of death as brain damage from a lack of oxygen due to an unknown injury more than a year before he died.

North Korea claimed Otto had contracted botulism, but US medics found no evidence to support this.

Mourners at Otto Warmbier's funeral (Image: REUTERS)

Otto Warmbier cries at court in North Korea (Image: Reuters)

Doctors had previously said he had no broken bones or marks on his body other than those which indicated medical treatment, the Enquirer reported.

They said he was deaf, blind, jerking uncontrollably and making "inhuman" sounds when they met him on a plane in Cincinnati after his sudden release from North Korea.

U.S. student Otto Warmbier is led away from North Korea's top court, in Pyongyang (Image: REUTERS/KCNA)

Otto Warmbier was detained for trying to steal an item bearing a propaganda slogan from his Pyongyang hotel (Image: Reuters)

His teeth also looked like they had been rearranged with pliers, they said, as they called Kim long-un and his regime "terrorists".

They also said he had a "huge scar" on his right foot and it was likely due to him living with an "open wound" for months.

However the coroner's examination only referred to a collection of small scars and stated that the University of Virginia student's teeth were "natural and in good repair".

It also mentioned that his eyes and ears showed "no remarkable alteration".

The coroner was limited to a visual examination because Mr Warmbier's parents did not want an autopsy.

Otto Warmbier died in June, just six days after he returned to the US after nearly 18 months in a North Korean prison (Image: REUTERS)

(Image: REUTERS)

Mr Warmbier's grief-stricken parents also told how they were not prepared to see him in a vegetative state.

His father told CNN of the moment he saw him, saying: "He has a shaved head, his eyes are darting around as big as saucers. He is blind, he is deaf he has a feeding tube. He is a complete vegetable.

"We weren't prepared for this at all. His hands and legs were totally deformed.

"Our family and Otto were humiliated by the North Koreans. Otto was tortured and essentially murdered."

The parents, from Wyoming, Ohio, told the Fox News programme Fox and Friends that they heard a 'howling, involuntary inhuman sound' as they walked up the steps to the plane that flew their son back to the US.

Mr Warmbier's father said: "We climbed to the top of the steps we looked in Otto was on the stretcher jerking violently making these inhuman sounds.

"Cindy and (Otto's sister) Greta ran off the plane."

He added: "As we looked at him and tried to comfort him it looked like someone had taken a pair of pliers and rearranged his bottom teeth."

Mr Warmbier said the couple had agreed to appear on TV because they were angry about North Korea claiming it was being victimised.

He added: "Now we see North Korea claiming to be a victim, that the world is picking on them, and we're here to tell you that North Korea is not a victim, they're terrorists."

Afterwards, President Donald Trump tweeted: "Great interview on @foxandfriends with the parents of Otto Warmbier: 1994 - 2017. Otto was tortured beyond belief by North Korea."

Trump and Kim have exchanged threats which have stoked tensions as North Korea ploughs ahead with its nuclear weapons programme.

The reclusive country is trying to develop a nuclear-tipped missile capable of hitting the US mainland, and has carried out a number of missile and nuclear tests in recent months despite UN sanctions.